Treatment Experience in a Local Population With Hidradenitis Suppurativa

Background: Treatment of hidradenitis suppurativa has been studied, but treatment strategies and outcomes have not been reported for a large community-based group of patients. Objective: We sought to determine the treatments most commonly prescribed and the performance of all systemic and surgical treatments used in hidradenitis suppurativa patients in Olmsted County, Minnesota, treated over a 40-year period. Methods: A retrospective chart review was performed to evaluate hidradenitis suppurativa treatments in 376 episodes with 115 Olmsted County patients seen by a clinician at Mayo Clinic in Rochester, Minnesota, between 1968 and 2008. Treatment episode outcomes were recorded from clinical notes for the 73 treatment episodes that had a follow-up period of more than 30 days. Results: Systemic antibiotics alone were prescribed most frequently in 70.0% of episodes. Systemic antibiotics alone improved 39 of 49 treatment episodes (79.6%), including 13 episodes (26.5%) when the disease was fully cleared. All 5 of 5 episodes (100%) of surgical treatment alone improved, including 4 (80%) in which the disease was fully cleared. Surgery in combination with systemic antibiotic treatment yielded improvement in 5 episodes (71.4%), with 2 episodes (28.6%) showing complete clearance. Conclusion: Systemic antibiotics were the most frequently prescribed treatment type in 115 patients over a 40-year period. Both systemic antibiotic therapy and surgical treatment are effective in disease management.